Patient and carer perspectives: a man with inoperable lung cancer

Patient and family perspectives are vital in conceptualising quality of life in the dying (1). The principles of a 'good death' have been established (2,3), and multidimensional frameworks exist for understanding and evaluating end-of-life care (4). However, care often falls short of the ideal, or is offered late. To examine why, we set out to understand the holistic needs of 40 patients dying from lung cancer or cardiac failure and their carers, and to explore to what degree these needs were identified and addressed by service providers (5). We chose qualitative methods as they can best explore such personal and sensitive issues as death and dying (6), and undertook serial interviews for up to one year with patients, their informal carers, and the professional carers identified by the patient as being most involved. Palliative care research calls for innovative patient- and carer-centred qualitative methods to complement quantitative findings (7). Interviews with one patient with lung cancer presented an especially graphic althoughn not atypical account, and these interviews are presented here. Case studies can stimulate the imagination, provoke, and perhaps disturb (8). Medicine retains an educational focus on the individual patient. We follow this tradition by presenting multifaceted data around one person.